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在不进行胰腺切除术的情况下切除与胰腺粘连的伴有巨大动脉瘤的脾动脉:病例报告

Removal of a splenic artery with a large aneurysm adhered to the pancreas without pancreatectomy: report of a case.

作者信息

Kitamura Hideki, Nakayama Kengo, Kitano Tadashi, Ozaki Nobuhiro, Nagaoka Saburou

机构信息

Department of Cardiovascular Surgery, Shimane Prefectural Central Hospital, Himehara-cho, Izumo, Japan.

出版信息

Surg Today. 2002;32(8):747-9. doi: 10.1007/s005950200141.

Abstract

Splenic artery aneurysms account for about 60% of all visceral aneurysms. The treatment include surgical procedures that sometimes require pancreatectomy. This report describes the case of a 64-year-old woman who had multiple splenic artery aneurysms with various visceral artery dilatations. Because there was no obvious cause for the splenic artery aneurysms and other arterial abnormalities, we suspected an anomaly of the connective tissue, which was subsequently confirmed by a postoperative histopathologic examination. Thus, we decided to remove the whole splenic artery, to eliminate the formation of any further aneurysms, as well as a splenectomy. During the operation, the largest splenic artery aneurysm was found to be adhered to the pancreas too tightly to ablate. It initially appeared that pancreatectomy would be necessary, but considering the associated risk of postoperative complications, we tried to avoid this. Thus, we cut open the aneurysm and excised it, leaving the anterior wall which was adhered to the pancreas. Our procedure proved the best way to preserve the pancreas and eliminate further aneurysmal formation.

摘要

脾动脉瘤约占所有内脏动脉瘤的60%。治疗方法包括有时需要进行胰腺切除术的外科手术。本报告描述了一名64岁女性的病例,她患有多个脾动脉瘤并伴有各种内脏动脉扩张。由于脾动脉瘤和其他动脉异常没有明显原因,我们怀疑是结缔组织异常,这一怀疑随后通过术后组织病理学检查得到证实。因此,我们决定切除整个脾动脉,以消除任何进一步动脉瘤的形成,同时进行脾切除术。手术过程中,发现最大的脾动脉瘤与胰腺粘连过紧,无法切除。最初看来有必要进行胰腺切除术,但考虑到术后并发症的相关风险,我们试图避免这样做。于是,我们切开动脉瘤并将其切除,留下与胰腺粘连的前壁。我们的手术方法证明是保留胰腺并消除进一步动脉瘤形成的最佳方法。

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